Depression in Mentally Handicapped Patients: Diagnostic and Neuroendocrine Evaluation

1986 ◽  
Vol 149 (3) ◽  
pp. 274-278 ◽  
Author(s):  
Lester Sireling
Keyword(s):  
Rating Scale ◽  
International Classification Of Diseases ◽  
Mentally Handicapped ◽  
Major Depressive ◽  
Classification Of Diseases ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Hamilton Rating Scale ◽  
Diagnostic Index

The dexamethasone suppression test was administered to 12 mentally handicapped depressed patients. One of the four patients with major depressive disorder, but none of those with other diagnoses, failed to suppress Cortisol production. The International Classification of Diseases and the Newcastle Diagnostic Index were found to be unreliable for use with severely mentally handicapped patients. Modifications are proposed which would allow the Research Diagnostic Criteria and Hamilton Rating Scale for Depression to be applied to patients with any degree of mental handicap.

Common Migraine versus Daily Chronic Headache: A Study of the Relationship Between Depression and Anxiety Scores, and Dexamethasone Suppression Test

Cephalalgia ◽  
1985 ◽  
Vol 5 (2_suppl) ◽  
pp. 215-217 ◽  
Author(s):  
Paolo Falaschi ◽  
Rosanna Cerbo ◽  
Gianluigi Di Cesare ◽  
Giuliana Cusimano ◽  
Renata Iellamo ◽  
...  
Keyword(s):  
Rating Scale ◽  
Depression And Anxiety ◽  
Significant Difference ◽  
Suppression Test ◽  
Daily Chronic Headache ◽  
The Relationship ◽  
Cortisol Suppression ◽  
Dexamethasone Suppression ◽  
Hamilton Rating Scale ◽  
Pituitary Adrenal Axis

To achieve a better understanding of CH and DCH, we used a multidisciplinary approach evaluating both the depression and anxiety scores and the ability of DEX to decrease plasma cortisol levels in patients with these two forms of headache. The Hamilton rating scale for depression, the Zung test for depression and Stai ×2 for anxiety showed scores within the control range in both groups of patients without any statistically significant difference between the groups. The DEX test showed significant cortisol suppression in both groups of patients either at 8 a.m. or at 4 p.m. (after DEX administration, 1 mg orally at 11 p.m. The night before). The results obtained indicate that in CM and in DCH, normal depression and anxiety scores exist in the present of the apparent integrity of the hypothalamic-pituitary-adrenal axis.

scholarly journals Defining anxious depression: a review of the literature

CNS Spectrums ◽  
2013 ◽  
Vol 18 (5) ◽  
pp. 252-260 ◽  
Author(s):  
Dawn F. Ionescu ◽  
Mark J. Niciu ◽  
Ioline D. Henter ◽  
Carlos A. Zarate
Keyword(s):  
Clinical Picture ◽  
Rating Scales ◽  
Rating Scale ◽  
International Classification Of Diseases ◽  
Anxious Depression ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
Clinically Significant ◽  
The Many

The diagnosis of anxious depression is presently inconsistent. The many different definitions of anxious depression have complicated its diagnosis, leading to clinical confusion and inconsistencies in the literature. This article reviewed the extant literature in order to identify the varying definitions of anxious depression, which were then compared using Feighner's diagnostic criteria. Notably, these suggest a different clinical picture of patients with anxious depression. For instance, relying on The International Classification of Diseases (ICD) or Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses yields a clinical picture of a comparatively mild or transient disorder; in contrast, using dimensional criteria such as DSM criteria combined with additional rating scales—most commonly the anxiety somatization factor score from the Hamilton Depression Rating Scale (HAM-D)—yields a more serious clinical picture. The evidence reviewed here suggests that defining anxious depression in a dimensional manner may be the most useful and clinically relevant way of differentiating it from other types of mood and anxiety disorders, and of highlighting the most clinically significant differences between patients with anxious depression versus depression or anxiety alone.

Dexamethasone suppression test in mentally handicapped subjects

1992 ◽  
Vol 9 (2) ◽  
pp. 101-105 ◽  
Author(s):  
Verena Keane ◽  
Saroj Soni
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Dexamethasone Suppression Test ◽  
Mentally Handicapped ◽  
Case Register ◽  
Affective Symptoms ◽  
Behavioural Difficulties ◽  
Abnormal Response ◽  
Suppression Test ◽  
Dexamethasone Suppression

AbstractObjective:This study investigated the frequency of abnormal Dexamethasone Suppression Test (DST) in a randomly selected group of mentally handicapped subjects.Method:Forty three subjects living in the community were selected and assessed on a variety of clinical rating scales including Hamilton Rating Scale for Depression (HDS) and Wessex Case Register Form (WCRF). DST was conducted on all the patients and the findings correlated with demographic and clinical variables. Groups defined by DST status were also compared using t-test. In subjects who showed an abnormal response, clinical assessments and DST was repeated after 3 months.Results:Only 7 of 43 subjects showed an abnormal response which did not correlate with either the severity of affective symptoms or the presence or absence of behavioural difficulties. Six of the 7 DST positive subjects were either severely or profoundly impaired on DSM-III criteria indicating that the underlying brain pathology may be pathogenetically important. This was supported by the observation that abnormal DST response was enduring at follow up.Conclusions:The findings suggest that DST may be of little value as a diagnostic tool in the mentally handicapped.

scholarly journals Convergence of children's depression rating scale-revised scores and clinical diagnosis in rating adolescent depressive symptomatology

2012 ◽  
Vol 4 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Paul L. Plener ◽  
Jasmin Grieb ◽  
Nina Spröber ◽  
Joana Straub ◽  
Alexander Schneider ◽  
...  
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
International Classification Of Diseases ◽  
German Version ◽  
Clinical Applicability ◽  
Interview Session ◽  
Children’S Depression ◽  
Classification Of Diseases ◽  
Icd 10

The Children's Depression Rating Scale-Revised (CDRS-R) is a widely used instrument for research on depression in minors. A raw score of ?40 has often been used as indicator of depressive symptomatology. As a validated German version of the CDRS-R has recently became available, we assessed CDRS-R raw summary scores of a video taped interview session in two different rater groups and compared them with clinical ratings of International Classification of Diseases (ICD-10) depression diagnosis as observed by a third independent group. We found that for the German version a raw score between 35 and 40 is indicative for mild depressive symptomatology as described by the ICD-10. CDRS-R scores show potential clinical applicability to deduct levels of depression.

The dexamethasone suppression test predictive of the therapeutic response to specific antidepressants

1987 ◽  
Vol 2 (1) ◽  
pp. 34-41
Author(s):  
H. D’Haenen ◽  
V.E. Morez ◽  
L. Kaufman ◽  
M.P. Derde
Keyword(s):  
Beck Depression Inventory ◽  
Therapeutic Response ◽  
Rating Scale ◽  
Dexamethasone Suppression Test ◽  
Double Blind ◽  
Psychiatric Interview ◽  
Number Of Patients ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Hamilton Rating Scale

SummaryThe value of the Dexamethasone Suppression Test (DST) in predicting the therapeutic response to a specific antidepressant is a very controversial topic, probably due to methodological issues. The aim of this study was to evaluate the power of the DST in predicting the response of primary and secondary depressives, diagnosed according to Feighner criteria, to either clomipramine or maprotiline. Patients were screened using standardized psychiatric interview, Current and Past Psychopathology Scales, the Hamilton Rating Scale for Depression (HRSD), and the Beck Depression Inventory (BDI); the Michigan Discriminant Index was determined providing an endogeneity score. A 1 mg DST was performed. Treatment was assigned double blind and at random, according to a fixed schedule with administration of up to 225 mg of either drug for three weeks. After this period patients were again evaluated with the Hamilton Rating Scale for Depression and Beck Depression Inventory, and a DST was again performed.Treatment reponse was defined in terms of reduction of HRSD and BDI scores. Serum levels of antidepressants were documented in a number of patients.HRSD score reduction did not yield any significant results.Insofar as BDI score reduction was concerned, nonsuppression on the DST (i.e. a post-dexamethasone cortisol value greater than or equal to 50 μg/l) predicted a better, or anyway a quicker, response to maprotiline; the DST results did not predict response in patients treated with clomipramine.Despite some methodological pitfalls (a relatively small group of patients, insufficiently documented serum antidepressant levels) these results seem to warrant further investigation in this field.

Comparison of Alcohol Use Disorders in DSM and ICD

2020 ◽  
Vol 66 (3) ◽  
pp. 143-153
Author(s):  
Jessica W. M. Wong ◽  
Friedrich M. Wurst ◽  
Ulrich W. Preuss
Keyword(s):  
Alcohol Use Disorders ◽  
International Classification Of Diseases ◽  
Clinical Use ◽  
Diagnostic Systems ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Historical Developments

Abstract. Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In this narrative review, we follow the historical developments in ICD and DSM with their corresponding milestones reflecting the scientific research and medical considerations of their time. The current diagnostic concepts of DSM-5 and ICD-11 and their development are presented. Lastly, we compare these two diagnostic systems and evaluate their practicability in clinical use.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Störungen durch Substanzgebrauch und abhängige Verhaltensweisen in der ICD-11

2020 ◽  
pp. 1-8
Author(s):  
Nicolas Arnaud ◽  
Rainer Thomasius
Keyword(s):  
International Classification Of Diseases ◽  
International Classification ◽  
Classification Of Diseases

Zusammenfassung. Der Beitrag informiert über die Eingliederung der Suchtstörungen in die 11. Auflage der International Classification of Diseases (ICD-11) der Weltgesundheitsorganisation (WHO). Die Revision der ICD soll einem gewandelten Verständnis der Suchtstörungen und deren Diagnostik Rechnung tragen und die klinische Anwendbarkeit vereinfachen. Im Bereich der substanzbezogenen und nicht substanzbezogenen Störungen sind gegenüber der Vorgängerversion erhebliche Neuerungen eingeführt worden. Die wichtigsten Änderungen betreffen ein erweitertes Angebot an Stoffklassen, deutliche (vereinfachende) Anpassungen in den konzeptuellen und diagnostischen Leitlinien der substanzbezogenen Störungsbilder und insbesondere der „Abhängigkeit“, sowie die Einführung der Kategorie der „abhängigen Verhaltensweisen“ und damit verbunden die Zuordnung der „Glücksspielstörung“ zu den Suchtstörungen sowie die Aufnahme der neuen (bildschirmbezogenen) „Spielstörung“. Zudem findet eine Erweiterung der diagnostischen Optionen für frühe, präklinische Phänotypen der Suchtstörungen („Episodisch Schädlicher Gebrauch“) erstmals Eingang in den ICD-Katalog. Im vorliegenden Beitrag werden die Änderungen Episodisch schädlicher Gebrauch für den Bereich der Suchtstörungen aus kinder- und jugendpsychiatrischer Sicht zusammenfassend dargestellt und diskutiert.

Zusatzklassifikation zur Kennzeichnung von Personen ohne akute Beschwerden oder Krankheiten)

1968 ◽  
Vol 07 (03) ◽  
pp. 141-151 ◽  
Author(s):  
H. Fassl
Keyword(s):  
International Classification Of Diseases ◽  
International Classification ◽  
Classification Of Diseases

In Krankenprotokollen finden sieb, nicht selten Angaben über den Patienten, die nicht mehr als Diagnosen anzusprechen sind. Dennoch sollten diese Feststellungen nicht verworfen werden, da sie wichtige Informationen darstellen. In der vorliegenden Arbeit wird (dem Vorschlag der Weltgesundheitsorganisation folgend) eine sog. Y-Klassifikation vorgestellt, mittels derer Feststellungen bei Personen ohne akute Klagen oder. Erkrankungen verschlüsselt werden können (z. B. Zustand nach einer Krankheit oder Verletzung, Verdacht auf eine Krankheit, Nachsorgemaßnahmen, prophylaktische Maßnahmen usw.). Der Entwurf folgt der Systematik der ICD (International Classification of Diseases) und kann dazu benutzt werden, gewisse Lücken darin zu überbrücken.

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